University of Southern Mississippi

Primary specialty

State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X

Legal business name

UNIVERSITY OF SOUTHERN MISSISSIPPI

Doing business as

Gulf Park Health Center

Practice address

117 Beach Park PL
Long Beach, MS 39560-6223

Phone

(228) 214-3300

NPI assigned

Aug 17, 2021

Last updated

Aug 17, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Lawanda Baskin, PHD, FNP-C

Title

Director

Phone

(601) 266-6081

Specialties & licenses 1

Addresses

Other names 1

• Gulf Park Health Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629158400000",
    "number": "1447926837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 BEACH PARK PL",
            "city": "LONG BEACH",
            "state": "MS",
            "postal_code": "395606223",
            "telephone_number": "228-214-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 BEACH PARK PL",
            "city": "LONG BEACH",
            "state": "MS",
            "postal_code": "395606223",
            "telephone_number": "228-214-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF SOUTHERN MISSISSIPPI",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-17",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A",
        "authorized_official_last_name": "BASKIN",
        "authorized_official_first_name": "LAWANDA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "601-266-6081",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, FNP-C"
    },
    "taxonomies": [
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gulf Park Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Price Tedford Jr., PHARMD
• The Healing Path, LLC
• Andrea Lyn Todd, PSY.D.
• Claire Jo Tuepker, LPC LMFT
• Anita Twiner-Watkins, LCSW
• Urgent Care of Long Beach LLC
• Vitas Laboratory LLC
• Amber-Nicole My-Linh Vu, RPH
• Danny Vu, PHARMD
• Jane Waldrop, P.T.

• State or Local Public Health Clinic/Center in Long Beach, MS
• Providers in Long Beach, MS by specialty
• State or Local Public Health Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.